A cough is considered chronic if it lingers for more than two months in adults and one month in children. Chronic coughing is quite common, affecting 11% of the population in the United States. That being said, chronic coughing is a symptom itself and needs to be treated by discovering the underlying cause. Curious about what causes chronic coughing? Then read on to learn more!

What Do Those With a Chronic Cough Experience?

Many symptoms come along with chronic coughing, some of which are less serious than others. This can include a runny or congested nose, heartburn, discomfort in the throat that requires regular throat clearing, a tickle in the back of your throat caused by postnasal dripping, as well as a fever (a temperature higher than 101 degrees Fahrenheit or 38.3 degrees Celsius).

More severe symptoms that can arise from having a chronic cough include weight loss due to inactivity, persistent hoarseness when speaking, coughing up blood or mucus, and even shortness of breath or wheezing. If you are experiencing such symptoms, consulting a doctor can help you get to the root cause of the coughing so that you can finally find relief.

What Are the Common Causes of a Chronic Cough?

The majority of chronic coughs are caused by one or more of the following conditions, sometimes even in combination:

Medications

One of the first causes of chronic cough to rule out is medication-induced cough. Lisinopril, an ACE inhibitor, is known for causing chronic cough related to its activation of bradykinin. This side effect can be bothersome for some individuals, and it is important to consider alternative medications for blood pressure if the cough becomes persistent or significantly affects quality of life.

The cough induced by lisinopril can develop at any time, even years after starting the medication. This phenomenon is known as delayed-onset cough. It is not fully understood why some individuals experience this side effect long after initiating lisinopril therapy, while others do not.

One possible explanation is that the cough is triggered by a cumulative effect of bradykinin accumulation over time. Bradykinin is a substance that causes blood vessels to dilate and can also irritate the airways, leading to coughing. As lisinopril inhibits the breakdown of bradykinin, it is believed that prolonged exposure to the medication may eventually result in the development of a chronic cough.

If a person experiences a persistent cough while on lisinopril, seeing your healthcare provider for further evaluation and to explore alternative treatment options is important.

Asthma

Asthma is a long-term disease that affects the lungs. It causes the airways to become inflamed, which makes it difficult to breathe. When someone with asthma is experiencing symptoms, their airways will tighten, inflame, and fill with mucus, making it harder to draw in air. While asthma can present itself differently in different people, coughing is often a common symptom of those with asthma, especially at night or in the morning.

Bronchiectasis

Bronchiectasis occurs when the tubes that carry air in and out of your lungs, known as bronchi, become damaged or thick. Because this makes it harder to breathe, the most common symptoms of bronchiectasis are coughing and shortness of breath. While fewer than 1 in 20,000 people aged 18-34 have this condition, the number rises dramatically to 1 in every 350 for those who are 75 or older.

Laryngopharyngeal Reflux

Laryngopharyngeal reflux, or LPR, is very similar to gastroesophageal reflux disease (GERD). However, it is sometimes called "silent reflux" because of its difficulty to diagnose. You may not have the classic symptoms of GERD if you instead have LPR, but one of the symptoms you will experience is coughing. The cough can sound like a hacking or “barking” cough as the contents of your stomach back up, which is known as reflux.

Chronic Sinusitis

Sinusitis is when the lining of your sinuses swells and becomes inflamed. A very common condition, sinusitis often has symptoms of facial pain/pressure, a swelling sensation in the face, mucus drainage, loss of smell, headaches, a runny nose, and bad breath. If the sinusitis lasts for three months or longer, it is referred to as chronic sinusitis. Because of the mucus drainage and the runny nose, an additional symptom some can have is coughing, which can also become chronic.

Conclusion

Coughing may be uncomfortable and disruptive but is part of the body’s defense against disease. While most cough go away on their own, you should contact your doctor if your cough lasts longer than three weeks. It’s important to not ignore a chronic cough, as it can be a sign of something serious.

If you are dealing with a chronic cough, it might be time to seek help. Dr. Thomas S. Higgins, MD, MSPH, is a top endoscopic sinus surgeon and can help assess how best to find relief for your current symptoms. Call 502-894-8441 or click here to book an appointment today!